SECTION 2
Client Care and Service
Community Focused
Continuing Care
Emergency/Trauma
Maternal, Child & Youth
Medical Care
Mental Health
Palliative Care
Specialized Intensive Care
Surgical Care

SECTION 3
Support Services
Information Management
Human Resources
Physical Environment

SECTION 4
Leadership/Partnership
Strategic Directions
Implementing Strategic Directions

Management of the Physical Environment

This team intends to add front line staff to the membership and this is supported as it will encourage innovation around service delivery. The current mutual support to find solutions and the ability to visualize the integrated system are key strengths. There is ongoing good response to clients, with needs identified through feedback forms, audits, and risk assessment tools.

There is a move toward purchasing equipment and supplies on a regional basis and this will increase over time. Current processes include CSA standards approval for all new equipment, and implementation of the inventory control policy. Any unsafe equipment or furnishing is either repaired or removed from service as soon as possible. The foundation is recognized for its contributions to equipment replacement.

Resources at ILPH (Inglewood Care Centre) are being managed effectively to ensure the safe delivery of care and service in the extended care and special care units, and the lodges and manor. Maintenance of building systems is through an external contract. In house staff provide on-site maintenance of equipment.

Recognition is given for exploring group purchasing of equipment and supplies by integrating with NSHR’s procurement processes. The organization is represented on the joint regional occupational health and safety committee and this also provides integration opportunities.

NSHR has established an infection control committee at the regional level to oversee the program. There is good adherence to pertinent legislation. Standard precautions are used at all times. Influenza vaccine is offered to all staff, first responders, and clients of residential facilities. Statistics are reviewed at four month intervals and all variances are analyzed. Staff receive broad education on any identified concerns. The surveillance screening for MRSA/VRE that is done on admission to some facilities will be extended to all regional facilities soon. Other screening is done for surgical wound infections and urinary tract infections. Infection rates are lower compared to other similar organizations and recognition is given for NSHR’s efforts in this regard. Specific surveillance programs continue to be developed. Infection control processes at ILPH (Inglewood Care Centre) are well established and include tracking through a software application program. Flu vaccine is available through a formal consent process.

An integrated emergency and disaster plan for the region is in draft and planning will continue in conjunction with individual municipal plans. Liaison officers are co­ordinating these efforts. A plan has also been developed to ensure ongoing communication and training of staff, volunteers and physicians regarding their response and role in the event of an emergency or disaster. Exercises will take place at the level of command and control on an annual basis. This will include testing the fan out procedure and procedures for ensuring continued care and service delivery. There is a procedure manual that outlines protocols for evacuation and relocation. A team has been designated to triage reception of mass casualties.

Disaster and emergency preparedness at ILPH (Inglewood Care Centre) includes formal agreements with other long term care facilities for support in the case of evacuation. The intent to include family members in evacuation planning is noted and supported. There is a link to NSHR for notification of incidents and recognition is given for standardizing codes in this regard. Good procedures are in place for preventing and responding to clients who are prone to wandering.

A process is under way to complete fire alarm and fire door upgrades across the region. This is being done in conjunction with fire department representatives. Emergency power sources were upgraded and tested as part of Y2K planning. Procedures are in place for the immediate shut down of systems.

All sites have developed protocols for dealing with incidents that pose a harmful or criminal threat such as hostage taking, bomb threats and aggressive behavior. Sites also have established guidelines for dealing with missing client situations, including monitoring clients prone to wandering.

Recognition is given for the quality improvement initiative that resulted in a new risk management system and implementation of standardized codes throughout the region. Orientation and education relevant to the new system are ongoing.

Recommendation:

3. Note is made of the plan to develop an organization-wide approach to fire drill exercises. For the most part, fire drills are occurring only on the afternoon shifts. Long term care sites appear to practice drills more frequently than other sites. It is recommended that NSHR develop and implement processes that will ensure the regular practice of fire drills on all shifts at all sites on a rotating basis. Drills must be evaluated by observers who prepare written reports. A major exercise that involves more than two services or units and which includes evacuation of real or simulated clients must be completed at least every three years. Repeat Recommendation (See Draft Standards for Comprehensive Health Services, 1997, Management of the Physical Environment, 5, 5.3, 6, 6.2.)